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Program highlights issues and progress in transgender health disparity

By Eddy Ball

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Organizers looked forward to the next generation of biomedical researchers, with their choice of NIH postbaccalaureate fellow Shane Scott, who identified as trans*, to deliver opening remarks. (Photo courtesy of Daniel Sone)

Tabak’s special assistant and NIH Office of Director LGBTI point person Rashada Alexander, Ph.D., introduced moderator Pendarvis. Alexander and two colleagues received a 2014 NIH Director’s Award for their leadership of the NIH LGBTI Working Group. (Photo courtesy of Daniel Sone)

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Pendarvis invoked the memory of earlier generations of trans* individuals. “I am reminded of those who are [now] voiceless,” he said. “We are the voices for them today.” (Photo courtesy of Daniel Sone)

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Corado, left, looked on as Scout followed up on a prompt from the moderator about how to advance inclusion in grant awards. “We’re clearly seeing the lack of knowledge in the peer reviewers,” he said. “Make sure the portfolios echo the commitment.” (Photo courtesy of Daniel Sone)

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Pointing to an explosion of literature by, and about, trans* people, Sapinoso told the audience, “You are not alone. There is a community.” (Photo courtesy of Daniel Sone)

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As an attorney concerned with equal employment opportunity for trans* individuals, Buchert’s job is often an uphill battle. “There’s rarely a smoking gun to prove employment discrimination,” she said. (Photo courtesy of Daniel Sone)

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Smith concluded the program by describing the children’s book he chose as a token of NIH appreciation for the panelists and moderator. (Photo courtesy of Daniel Sone)

The National Institutes of Health (NIH) Office of Equity, Diversity, and Inclusion marked yet another first, this June, with a panel discussion on transgender health disparity. The program kicked off Lesbian, Gay, Bisexual, Transgender, and Intersex (LGBTI) Pride Month.

Linked Video

“On Being Human: Reflections on Trans* [Transgender] Health and Wellbeing” brought together five leading trans* activists and researchers June 10 at NIH in Bethesda, Maryland. Prompted by questions from moderator
Rayceen Pendarvis, a prominent Washington, D.C., author and columnist, panelists shared personal experiences about trans* issues, through the perspectives of health, research, employment, law, and culture.

The panel was part of the Special Emphasis Program on LGBTI at NIH, led by strategist Albert Smith Jr., with support from the NIH Office of the Director, National Institute for Minority Health and Health Disparities, and a network of several other groups and individuals at NIH.

“Our stories matter,” Smith told the audience as he described the program’s narrative format. “And I think today’s panel is a testament to that saying.”

The event was groundbreaking, with several new initiatives mentioned by the panelists, in addition to positive developments underway at NIH aimed at greater inclusion of trans* individuals (see text box).

In search of safe spaces

Panelists included nationally recognized voices in the trans* communities —
Scout, Ph.D., professor at Boston University and director of CenterLink’s Network for LGBT Health Equity;
Ruby Corado, founding director of Casa Ruby in Washington, D.C.;
Sasha Buchert, J.D., staff attorney with the Transgender Law Center in Oakland, California; and
JV Sapinoso, Ph.D., assistant director of LGBT studies at the University of Maryland in College Park.

Their personal narratives offered insight into the quest of individuals and communities to validate identity in a society that is still struggling to understand fundamental differences between biological determination of sex and psychosocial constructions of gender.

The stories explored the effects of marginalization on the life experiences of a population facing health disparities linked to some of the highest unemployment and poverty rates in the U.S. today. Trans* health is disproportionately affected by higher rates of sexually transmitted disease, discrimination in virtually every aspect of life, homelessness, widespread alienation from family and traditional community, hate crimes, suicide attempts, and violence.

Celebrating identity and progress

Against this backdrop of exclusion, persistent marginalization, and the reality that society has not yet formally recognized LGBT individuals as a population with health disparities, panelists could still point to some signs of progress.

In final remarks, Pendarvis cited a growing number of stories about families who are embracing gender difference in their children, and singled out NIH for its leadership in inclusion. “We are beginning to tear down barriers and build understanding, and we applaud NIH [for its contribution] to this big step,” Pendarvis said. “Let this be the beginning of a series of dialogue.”

Smith made a fitting choice as a gift for panelists — “Hooray for You: A Celebration of ‘You-Ness,’” — a children’s book of self-affirmation and inclusion. “This book will change your life,” he said. “It reminds me of how important it is for me to be me and for you to be you.”

Beginning a long journey with bold first steps

The 2014 Pride Month
statement by NIH Director Francis Collins, M.D., Ph.D., underscored the strong commitment to LGBTI inclusion and equal employment opportunity by leadership at NIH and the U.S. Department of Health and Human Services (HHS), which held its own celebration of Pride Month June 12. As Scout’s own funding suggests, federal agencies are also beginning to show support for trans* health research, although barriers remain with the wording of requests for applications and in the peer review process. Scout also pointed to positive efforts to educate healthcare providers, through grand rounds continuing medical education programs on gender-specific needs of trans* patients.

After years of struggle, Buchert can now point to a handful of gender discrimination cases her clients have won, as well as to the 17 states that have adopted some degree of protection for individual gender identity determination. Several universities have established programs to encourage student involvement in LGBT community programs, and the body of literature on trans* issues is growing dramatically, including the nearly 700-page “Trans Bodies, Trans Selves: A Resource for the Transgender Community,” and a new journal, Transgender Studies Quarterly.

On a personal level, panelists responded positively to a question from Pendarvis about the meaning of LGBT pride. “It means I’ve overcome my inner transphobia,” Buchert said. According to Corado, it has helped her, as a trans* Latina, negotiate mainstream society with greater assurance. “LGBT pride is also about responsibility and accountability, and the privilege to speak,” added Sapinoso.

“On Being Human” was the first of three transgender education and sensitivity training events, in June, sponsored by NIH as a part of its 2014 LGBTI Pride Month observance. In keeping with a
proclamation by President Obama, other federal agencies are also sponsoring Pride Month observances.

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